Abstract

Objective: We aimed to explore the predictive value of clinical features and self-concept on methylphenidate (MPH) response in children with attention deficit/hyperactivity disorder (ADHD).
Methods: The study had a naturalistic design where the results were analyzed retrospectively. ADHD and comorbidity were diagnosed by Schedule for Affective Disorders and Schizophrenia for School-Age Children Present Lifetime Version (K-SADS-PL). At the baseline assessment, parents completed Turgay DSM-IV Disruptive Disorders Rating Scale (T-DSM-IV-S) and Child Behavior Check List (CBCL); teachers were given T-DSM-IV-S, CBCL. The children completed Piers-Harris Children’s Self-Concept Scale (PHSCS), Children’s Depression Inventory (CDI), and Screen for Child Anxiety Related Emotional Disorders (SCARED). Following 4-8 weeks of MPH treatment, the parents completed T-DSM-IV-S and the clinician completed Clinical Global Impression-Improvement scale (CGI-I). This study included 54 children (18 girls, 36 boys; mean age 9.32±0.21 years old). The sample was divided in “good responders” (GR) and “poor responders” (PR) regarding the response criteria defined by authors.
Results: The PR group had significantly higher rates of anxiety disorders, higher internalizing scores and lower PHSCS scores compared to GR. Comorbid anxiety disorders, elimination disorders and negative self-concept were found to predict poor MPH response by multiple regression analysis.
Conclusions: The results point to the need for additional interventions in the presence of comorbid anxiety, incontinence or poor self-concept in children with ADHD.

Key words: ADHD, anxiety, enuresis, methylphenidate, self-concept